The childhood obesity epidemic continues relatively unabated, and a higher prevalence of obesity among low- income children is already present in the preschool age range. It is well-recognized that parenting style impacts obesity risk, and parenting style was included in the Expert Recommendations for the Prevention, Assessment, and Treatment of Childhood Obesity. Despite the perceived importance of maternal feeding styles to childhood obesity risk, the characterization of maternal feeding styles remains relatively simplistic and their potential change over time, particularly in relation to the child's weight status, is nearly entirely unexplored. An improved understanding of maternal feeding styles as well as how they change over time in response to changes to a child's weight status is needed to inform and tailor interventions. The proposed project therefore seeks to identify maternal feeding styles among low-income mothers of 4- to 6-year-old children. We focus on this population given the high prevalence of obesity within this group, and the remarkable lack of prior work in this area with low-income families. We have also conducted substantial preliminary work that has identified preliminary maternal feeding styles. One of these feeding styles we call Conflicted Controllers, and more than half of the children of mothers with this feeding style are obese. This project therefore also will seek to better understand this specific feeding style and its development in relation to child weight status. The project team is uniquely positioned to address this research question. The Principal Investigator was awarded an NIH Challenge Grant to examine relationships between stress, eating behavior, diurnal salivary cortisol, and obesity risk among low-income 3- to 5-year-old children. Data collection is proceeding ahead of schedule, and we anticipate enrolling 350 children by August 2011. We propose to address 4 aims with 300 participants, drawing most participants from this existing cohort. The aims are: Aim 1: To identify maternal feeding styles using a multi-method approach. Aim 2: To identify differences in body mass index z-score and the prevalence of child obesity across maternal feeding styles at baseline. Aim 3: To examine transitions from one feeding style to another over a two year period. Aim 4: To determine if changes in child body mass index z-score predict transition from one feeding style to another. Our multi-method approach to identifying feeding styles will include a well-developed semi-structured interview about feeding from which we will code maternal confidence, authority, and investment using a well-established coding scheme; videotaped maternal-child interactions during feeding both in the laboratory and at home which we will code using a reliable and validated scheme; and a series of questionnaires. The results of this project will contribute to more tailored and effective interventions for obesity prevention and treatment. PUBLIC HEALTH RELEVANCE: Childhood obesity is a growing public health problem, and low-income populations carry the greatest burden of the obesity epidemic. Obesity that develops in childhood is very likely to track into adulthood, and is associated with a large number of adverse health, behavioral, and social outcomes. An improved understanding of maternal feeding styles, particularly within low-income populations, would inform the development of more effective intervention and prevention programs.